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At least 73 records · Page 4Linked to original sources
PubMed2004

Is diverticulosis associated with colorectal neoplasia? A cross-sectional colonoscopic study.

OBJECTIVE: To determine the relationship between distal diverticulosis and risk for colorectal neoplasia. METHODS: Patients undergoing first-time colonoscopy for any indication were eligible if they had no prior polypectomy, colonic resection, or inflammatory bowel disease. Patients completed a survey about risk factors for colorectal cancer (CRC) prior to colonoscopy. Endoscopists, blinded to study objective and survey results, recorded the size, extent (none, few, or many), and location of diverticuli and polyps. RESULTS: The 502 participants were 67% male with a mean age of 58.6 yr. Twenty-three percent had extensive distal diverticulosis (EDD), 36% had > or =1 adenoma, and 14% had advanced neoplasia. Overall comparison of those with EDD versus few or no diverticuli revealed no differences in the risks of any neoplasia or advanced neoplasia, either distally (26.7%vs 25.4%; 12.9%vs 8.8%, respectively) or proximally (25%vs 18.4%; 6.0%vs 4.9%). Compared to women with few or no distal diverticuli, however, women with EDD were more likely to have any neoplasia and advanced neoplasia, both distally (34.6%vs 16.3%; p= 0.03, and 23.1%vs 5.7%; p= 0.003) and proximally (30.8%vs 14.9%; p= 0.049, and 11.5%vs 4.3%, p= 0.13). Adjustment for age did not affect results for advanced distal neoplasia (OR = 3.92; CI: 1.18-13); however, adjustment for the presence of a distal neoplasm eliminated the increased risk of proximal neoplasia associated with EDD (OR = 1.31; CI: 0.43-4.02). CONCLUSION: In this study, women with EDD were more likely to have advanced distal neoplasia. The presence of distal neoplasia in women with EDD accounted for their increased risk of proximal neoplasia. Distal diverticulosis was not independently associated with proximal neoplasia in men or women.

Colonoscopy↗
PubMedDate not supplied

[Intestinal hemorrhage from diverticulosis of the jejunum: a case report].

The diagnosis of intestinal diverticulosis is difficult to achieve preoperatively because the clinical symptoms are usually non-specific. Intestinal bleeding is a rare complication of jejunal diverticulosis. Its diagnosis and treatment can be difficult and an emergency laparotomy is often needed. We report a case of massive intestinal bleeding from jejunal diverticulosis. The correct diagnosis was first suggested by CT and then confirmed at laparotomy. The treatment was a segmental jejunal resection with primary anastomosis.

Aged, 80 and over↗
PubMed1991

Jejunal diverticulosis: case report of a rare cause of mechanical intestinal obstruction.

Jejunal diverticulosis is a rare condition and usually discovered incidentally at laparotomy for an unrelated pathology. When inflamed or perforated, jejunal diverticulosis may present with paralytic ileus. In contrast, mechanical bowel obstruction is an unusual presentation. This paper reports the first local case of jejunal diverticulosis presenting with mechanical bowel obstruction due to impaction at the terminal ileum by an enterolith originating from a diverticulum, and reviews the recent literature on the subject.

Aged↗
PubMed1987

[Intramural diverticulosis and cancer of the gallbladder].

Two cases of gallbladder carcinoma occurring in intramural diverticulosis (adenomyomatosis) are reported. The first was adenocarcinoma associated with cholesterolosis without gallstone formation. The second was squamous cell carcinoma. Four other carcinomas developing on diverticulosis were reported in the literature, none of them being squamous cell carcinoma. Our cases and those of the literature show that diverticulosis, a benign condition, can be associated with carcinoma which can make the pathological diagnosis difficult.

Adenocarcinoma↗
PubMed1984

Jejunal diverticulosis with perforation as a complication of Fabry's disease.

This study presents the case of a patient who had jejunal diverticulosis with perforation and abscess formation as a complication of Fabry's disease. Light microscopy disclosed glycolipid deposition in the neurons and nerve fibers of the intestinal nerve plexuses and smooth muscle. Silver stains of the myenteric plexus in the involved segment of the bowel showed enlarged, granular argyrophobic neurons and a marked decrease in the number of argyrophilic neurons, with those remaining being enlarged and distorted by the cytoplasmic glycolipid accumulation. These abnormalities of the myenteric plexus suggest that jejunal diverticulosis may be the result of a variety of disorders of the smooth muscle or myenteric plexus, or both. We propose that jejunal diverticulosis in our patient was a consequence of uncoordinated smooth muscle activity resulting from Fabry's involvement of myenteric plexus neurons, with mucosal protrusion through the smooth muscle.

Abscess↗
PubMed1981

[Diverticulosis of the digestive tract in our patients over a 10-year period].

Incidence, localization and clinical characteristics of diverticulosis of the digestive tract detected within the period 1971-1980 are analysed. Of 12.352 examined patients, diverticulosis was found in 425 (3,44%). The largest number was detected radiologically and some endoscopically. Diverticulosis was most commonly found in: colon 355, duodenum 42, eosophagus 20 and small intestine 16 (of them 11 with Meckel's) and most rarely in the stomach, 12 patients. Symtomatology was non-characteristic. The treatment was conservative, except in the case of complications. Complications occurred in 39 (9,2%) patients. Due to complications, Meckel's diverticuli were actively searched for and all cases were operated on.

Adolescent↗
PubMed1993

Jejunal diverticulosis.

Jejunal diverticulosis is considered to be a generally asymptomatic condition in which the diverticula are pulsion mucosal herniations with walls lacking a muscle layer. These opinions in particular are examined in this review of 20 cases of jejunal diverticulosis treated during an 8 year period. The predominant complication in each case was inflammation or perforation (nine), diarrhoea or malabsorption (five), haemorrhage (three), chronic abdominal pain (two) and pseudo-obstruction (one). At least 10 patients had more than one complication, although this was often unrecognized. Ten patients complained of chronic abdominal pain, in eight of whom the cause was not diagnosed until other complications supervened. Unrecognized malabsorption may be common, as the mean serum albumin in 12 patients presenting acutely with inflammation, perforation or haemorrhage, was low (mean 32 g/L, normal 39-48 g/L). Histology sections were reviewed in the 12 cases that underwent resection, of whom 11 were suitable for classification. Four cases had narrow-mouthed pulsion diverticula with a thin or absent muscle coat, and had developed at the point of blood vessel penetration. Four cases had wide-mouthed diverticula in which the muscle layer was present, suggesting an abnormality of the intestinal wall. Two had features of both. In one case a Meckel's type diverticulum was located 10 cm from the duodenal-jejunal flexure. Seven had mucosal villous atrophy consistent with bacterial overgrowth. In conclusion, jejunal diverticulosis may be associated with complications more frequently than has been recognized and pathologically is a diverse condition.

Aged↗
PubMedDate not supplied

[Use of an x-ray method in the assessment of changes in the intestinal wall in colonic diverticulosis].

The authors analyze x-ray findings in 194 patients with colonic diverticulosis and its inflammatory complications. Findings of preoperative irrigoscopy were correlated with dates of morphological investigations. Roentgenomorphological and functional changes were assessed in different clinical types of colonic diverticulosis. Correlation was received between this changes and clinical sings of disease. Authors determined risk-groups of inflammatory complications of colonic diverticulosis.

Calcinosis↗
PubMed1995

[Radiologic image of massive diverticulosis of the small intestine].

Diverticulosis of the small bowel is rare compared with diverticular disease of the colon. Diverticulosis of the duodenum is more common than the involvement of the whole small bowel including the ileum which is a very rare condition. In a patient presenting with gastrointestinal bleeding extensive diverticulosis of the whole small bowel was identified; the etiology is discussed.

Aged↗
PubMed1979

Jejunal diverticulosis and chronic pneumoperitoneum.

A unique case of pneumoperitoneum, without peritonitis or perforation, associated with jejunal diverticulosis is presented. Pneumoperitoneum is documented over the course of many years, with recurrence after partial small bowel resection. Jejunal diverticulosis is one of the leading gastrointestinal causes of pneumoperitoneum without peritonitis or surgery. The distended diverticular mucosa may function as a semipermeable membrane allowing transmural gas equilibration.

Aged↗
PubMed1989

Rectal diverticulosis: a case report and review of the literature.

The occurrence of rectal diverticulosis is rare. We report the incidental finding of a large rectal diverticulum in a patient receiving an air-contrast barium enema. The presence of uncomplicated rectal diverticulosis is probably of little clinical significance. However, there can be associated complications such as inflammation and perforation, and potential confusion with rectal carcinoma.

Aged↗
PubMed2000

Recent trends in diverticulosis of the right colon in Japan: retrospective review in a regional hospital.

PURPOSE: Diverticulosis of the right colon has been increasing in the Far East; however, a considerable proportion of these patients includes cases of solitary right-sided diverticular disease. This study aimed to determine whether the incidence of such solitary diverticula (defined as 1 or 2 diverticula in this study) and multiple (3 or more) diverticula of the right colon is increasing in Japan. METHODS: A total of 13,947 consecutive barium enema examinations, performed in the period from 1982 to 1997, were reviewed. Changes in the frequency (detection rate) and number of diverticula across time and with aging of three types of diverticula, right-sided, left-sided, and bilateral, were investigated, with special interest in those patients with one or two diverticula of the right colon. RESULTS: Right-sided and bilateral diverticula have increased in frequency across time; however, left-sided diverticula have not. Patients with one or two diverticula in the right colon of right-sided disease, unexpectedly, have increased across time in both genders, and patients with three or more diverticula in the right colon of right-sided disease have shown an increase in males. The number of diverticula of the right colon showed no increase across time or with aging. CONCLUSIONS: Diverticulosis of the right colon, both solitary and multiple, has been increasing steadily in Japan; therefore, diverticulitis and bleeding diverticula of the right colon may continue to increase. Diverticula of the right colon might be an acquired disease and self-limiting in development, because the frequency did not increase substantially in the elderly and because the number changed little across time and with aging.

Aged↗
PubMed2005

[Diverticulosis and diverticulitis].

Alterations in the colon wall, motility disorders, and certain nutritional habits are the essential factors in the development of colon diverticula. Thus, with advancing age this results in a high incidence in Western industrialized countries. The clinical picture is usually one of symptom-free diverticulosis. Diverticular disease can be associated with minor symptoms, but in complicated cases with diverticulitis and diverticular hemorrhage, it is potentially fatal. Further complications include abscess formation, fistula development, and obstruction. Barium double-contrast imaging exhibits the highest diagnostic sensitivity in diverticulosis but is contraindicated in cases of suspected complicated diverticular disease due to the danger of perforation. In these instances, sonography, computed tomography, or magnetic resonance imaging are performed. For diverticular hemorrhage, coloscopy not only represents a possible diagnostic tool but also a therapeutic option for various techniques of hemostasis. Treatment of diverticulitis and its complications requires careful consideration of conservative and surgical approaches and close interdisciplinary cooperation.

Diverticulitis↗
PubMed2005

Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report.

Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and C-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.

Aged↗
PubMed1998

Jejunal lipomatosis with diverticulosis: report of a case.

We herein report the very rare case of a 68-year-old Japanese man with multiple jejunal lipomatosis and diverticulosis. He was admitted to our hospital with the chief complaint of melena and anemia. A barium study of the small bowel showed multiple lipomatosis and diverticulosis. An approximately 200-cm length of the jejunum was therefore resected. Thereafter, two diverticula and 215 lipomas were recognized in the resected specimen. A pathological examination showed mature adipose tissue with fibrous septa in the submucosal and muscularis propria. These findings were thus suggested to be due to the attenuation of the muscularis propria. The complications of lipomatosis are also discussed.

Aged↗
PubMed2003

Small Bowel Diverticulosis: An Overlooked Entity.

Small bowel diverticulosis (SBD) is a rare entity. Most cases of diverticulosis are asymptomatic. SBD is often discovered incidentally during contrast studies and endoscopy. When patients report chronic gastrointestinal symptoms such as abdominal pain, bloating, flatulence, and anemia, SBD is often an overlooked diagnosis. Patients requiring treatment for SBD are those with complications such as malabsorption, hemorrhage, obstruction, and acute inflammation with abscess or rarely perforation. Malabsorption can be managed with broad-spectrum antibiotics and vitamin supplementation. Hemorrhage is treated conservatively with resuscitation efforts, but recurrent bleeding requires surgery. Enteroliths causing obstruction in the duodenum can be relieved by endoscopy, that is, by manipulation, but jejunoileal obstruction requires a resection. Pseudo- obstruction may be managed with prokinetics such as metoclopramide, erythromycin, and the 5-hydroxytryptamine 4 agonist tegaserod. Uncomplicated cases of SBD are treated with bowel rest and antibiotics. However, perforation or abscess formation not amenable to percutaneous drainage mandates surgical resection. Any patient with a triad of anemia, abdominal pain, and an abdominal radiograph with dilated loops of small bowel merits SBD in the differential diagnosis.

Journal Article↗
PubMed2005

Small-bowel diverticulosis.

Diffuse jejunoileal diverticulosis with pneumoperitoneum but without peritonitis is an uncommon but well-documented entity. Cases of jejunoileal diverticular perforation in which the perforation is evident are managed with resection of the diseased bowel and primary anastomosis. In the absence of an intraoperative finding of a perforation or an area of discrete inflammation, copious irrigation and closure of the abdomen is appropriate in cases of diffuse small-bowel diverticulosis.

Abdominal Pain↗
PubMed1975

Recurrent pneumoperitoneum due to jejunal diverticulosis. With a review of the causes of spontaneous pneumoperitoneum.

In the absence of abdominal operative procedures, symptomless spontaneous pneumoperitoneum is uncommon. The case is described of a patient with jejunal diverticulosis who developed spontaneous pneumoperitoneum on three occasions and brief details are given of six other cases of jejunal diverticulosis with pneumoperitoneum from the literature. Other causes of symptomless pneumoperitoneum include pneumatosis intestinalis, perforation in tabes dorsalis or coma, stercoral ulceration, physiological pneumoperitoneum in women due to exercise in the knee-elbow position, and vaginal douches with a bulb syringe or effervescent fluid.

Aged↗